Individual
MR. ROGER ALLEN DESALME JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1615 OJO COURT, FARMINGTON, NM 87401
(505) 564-4804
(505) 564-4857
Mailing address
1615 OJO COURT, FARMINGTON, NM 87401
(505) 564-4804
(505) 564-4857
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
16736
TX
101YP2500X
Professional Counselor
Primary
CCMH0205461
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CCMH0205461
CLINICAL PROFESSIONAL COUNSELOR
NM
Enumeration date
08/14/2006
Last updated
08/14/2019
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